Rectal shaving using PlasmaJet in deep endometriosis of the rectum

Abstract

Objective: To report an original technique of rectal shaving using the PlasmaJet system (Plasma Surgical, Inc.) for the management of deep endometriosis of the rectum.

Design: Video demonstration of a new surgical technique.

Setting: Hospital.

Patient(s): A 34 year-old primipara with a deep endometriosis involving the vagina and the mid-rectum over 30 mm.

Intervention(s): An original technique of rectal shaving.

Main outcome measure(s): The procedure is based on the specific properties of PlasmaJet: the lack of lateral thermal spread around the jet of plasma making the dissection on contact of rectal wall safe, the precise ablative property allowing for in situ ablation of rectal endometriosis implants, and the kinetic energy enhancing the dissection of subperitoneal spaces. The steps of the technique and the role of PlasmaJet are emphasized. The surgical technique report using anonymous patients is exempt from ethical approval by the IRB.

Result(s): The patient's outcome was uneventful, and colorectal complaints were completely relieved one week after surgery. Since November 2012, we have employed this technique in 18 patients, with only favorable outcomes.

Conclusion(s): The technique described in this video article may represent a step toward a more complete removal of endometriotic implants and better colorectal outcomes.

Keywords: Deep endometriosis; PlasmaJet; plasma energy; rectal endometriosis; rectal shaving.